Question: The proposal presents a Quality Management model to avoid fraud and waste in Health Care Operators. In Brazil we have 679 Health Operators, with 50

The proposal presents a Quality Management model to avoid fraud and waste in Health Care Operators. In Brazil we have 679 Health Operators, with 50 million beneficiaries, generating revenue of 264 billion (4 quarter 2022), and with a claim rate of 89%, this claim already indicates a possible unfeasibility of the operation. It is estimated that 11% of Operators' expenses are fraud or waste.

Step by Step Solution

★★★★★

3.48 Rating (161 Votes )

There are 3 Steps involved in it

1 Expert Approved Answer

Step: 1 Unlock

Quality Management Model to Address Fraud and Waste in Brazilian Healthcare Introduction The Brazilian healthcare system serves a massive population w... View full answer

Question Has Been Solved by an Expert!

Get step-by-step solutions from verified subject matter experts

Step: 2 Unlock

Step: 3 Unlock

Students Have Also Explored These Related Accounting Questions!

Managing Scope Changes Case Study Scope changes on a project can occur regardless of how well the project is planned or executed. Scope changes can be the result of something that was omitted during...

The Crazy Eddie fraud may appear smaller and gentler than the massive billion-dollar frauds exposed in recent times, such as Bernie Madoffs Ponzi scheme, frauds in the subprime mortgage market, the...

KEEP EMPLOYEES HEALTHY Controlling Health Status and Healthcare Cost of Employees Force 6: Employee Health. With the dramatically increasing cost of healthcare and the fact that in the United States,...

CAFR Mini-Project Goal To research and analyze the Comprehensive Annual Financial Report of a US city with a population of at least 100,000. Choose your City Download the most recent CAFR of a city...

What was the acquisition premium and what do you conclude from it regarding the fairness of the deal? What was the market reaction to the acquisition announcement and what do you conclude from it...

In the case "H. J. Heinz M&A" how can I financially analyze the company so I can come up with a recommendation at the end? What kind of financial analysis should I do? I attached below the case. I...

15. Identify several of the operating metrics (ratios) at the end of the HCA July 29 earnings announcement. Explain how they describe specific trends that affect HCA?s financial results. Which of...

I need this done using your own work. I need to see how you got the answers and try to show work s we look back on 2014, we are pleased with our accomplishments. We continued to focus for many...

Project 1: Analysis of a 10- K (10%) 1. Locate a 10-K of your choice from the SEC website (www.sec.gov). Present your choice in the conference set up for same in Week #1 for approval by stating the...

The curve for which y" = 6 has a slope of -3 at its | point of inflection (2, 3). Find the value of y at x = 1. . 5 . 8 . 14 D. 17

Test not useful in case of tubal pregnancy: a) Pelvic examination b) USG c) HCG levels d) Hysterosalpingography

1.4 A charge of 2 C flowing past a given point each second is a current of 2 A. (a) True (b) False

a. Construct a personal income statement for the Humperdinck family using the following information: salaries, $42,000; mortgage payment, $7,980; food, $2,400; interest income, $150; transportation,...

Use the Target Corporation's Form 10-K to answer the following questions related to Target's 2015 fiscal year (year ended January 30, 2016). Target's Form 10-K is available on the company's website...

Suppose 1 year ago, Miller Company had inventory in Britain valued at 1.5 million Swiss francs. The exchange rate for dollars to Swiss francs was 1 franc = 1.15 dollars. Today, the exchange rate is 1...

Anderson, Macer, and Bell have capital balances of $22,000, $33,000, and $55,000, respectively. The partners share profits and losses as follows: a. The first $50,000 is divided based on the...

Accounts from the adjusted trial balance at September 30, 2015, are listed in alphabetical order below for Ozaki Corp.: Instructions (a) Prepare an adjusted trial balance. (b) Prepare the closing...

US Army Ranger Ahmed and his wife, Shanequa, moved to Kansas on January 1 st , 2 0 2 4 , due to Ahmed's Permanent Change of Station order. Ahmed s Home of Record is Georgia, which Shanequa also...

Why is earnings management considered a trick of the trade? Explain.

Do you believe that a businesss carbon footprint will be an important competitive issue in the future?

In the opening vignette, why do you think Sanford Weill believed it was important to stay on as chairman of the board after Charles Prince was picked as the new CEO? Why did three top-level employees...

The multiple regression relationships of SBP (Y) to AGE (X1), SMK (X2), and QUET (X3) are studied. Three regression models are considered, yielding least-squares estimates and ANOVA tables as shown...

Use the data set of Problem 1 in Chapter 5 to answer the following questions. In Problem 1, Chapter 5 a. Determine the ANOVA tables for the following regressions: (1) dry weight (Y) on age (X) and...

Radial keratotomy is a type of refractive surgery in which radial incisions are made in the cornea of myopic (nearsighted) patients in an effort to reduce their myopia. Theoretically, the incisions...